糖尿病

什么是糖尿病?

There are two forms of diabetes in dogs: diabetes insipidus and diabetes mellitus. Diabetes insipidus is sometimes called “drinking diabetes” and diabetes mellitus is also known as “sugar diabetes.” Diabetes insipidus is a very rare disorder that results in failure to regulate body water content. 糖尿病在dogs身上更常见, 并且经常在5岁或5岁以上的dogs身上被诊断. 这也被称为II型或成人发病糖尿病. There is a congenital form that occurs in puppies called Type I or juvenile diabetes, 但这在dogs身上很少见.

胰腺解剖:糖尿病是一种胰腺疾病. 这是一个位于胃附近的小而重要的器官. 它有两个重要的细胞群. 一组细胞产生适当消化所必需的酶. 另一组被称为β细胞,产生胰岛素激素. Simply put, diabetes mellitus is a failure of the pancreatic beta cells to regulate blood sugar.

一些糖尿病患者注射胰岛素,其他人口服药物. 这对dogs来说是真的吗?

在人类中,发现了两种糖尿病. 这两种类型的相似之处在于无法调节血糖, 但这两组人的基本发病机制有所不同. Most dogs with diabetes mellitus will require daily insulin injections to regulate their blood glucose.

1型或胰岛素依赖性糖尿病, 完全或几乎完全破坏细胞的结果. 这是dogs最常见的糖尿病类型. 顾名思义, dogs with this type of diabetes require insulin injections to stabilize blood sugar.

II型或非胰岛素依赖型糖尿病, 不同是因为有些产生胰岛素的细胞仍然存在吗. 然而, 生产的数量不够, 隐藏它会有延迟反应, 或者dogs的身体组织对它有相对的抵抗力. II型糖尿病最常见于年龄较大的肥胖dogs. People with this form may be treated with an oral drug that stimulates the remaining functional cells to produce or release insulin in an adequate amount to normalize blood sugar. 不幸的是,dogs对这些口服药物的反应并不好.
 

为什么胰岛素如此重要?

实际上,胰岛素的作用很像把关人, 它位于人体细胞的表面,为细胞开门, 使葡萄糖离开血液进入细胞. 葡萄糖是一种重要的物质,它提供了生命所需的大部分能量, 它必须在细胞内工作. 没有足够的胰岛素,葡萄糖就无法进入细胞. It accumulates in the blood, setting in motion a series of events that can ultimately prove fatal.

胰岛素缺乏时口渴增加, 这些细胞变得缺乏能量来源. 作为回应, the body starts breaking down stores of fat and protein to use as alternative energy sources. As a consequence, the dog eats more; thus, we have 重量 loss in a dog with a ravenous appetite. 身体试图通过尿液排出多余的葡萄糖. 然而, glucose (blood sugar) attracts water resulting in the production of a large amount of urine. 为了避免脱水,dogsdogs喝了越来越多的水. 因此,bwin体育有四种典型的糖尿病症状:

1. 减肥
2. 增加水消耗量
3. 增加食欲
4. 增加排尿
 

如何诊断糖尿病?

The diagnosis of diabetes mellitus is based on three criteria: the four classical clinical signs, 血糖过高血液中葡萄糖浓度持续过高, 以及尿液中葡萄糖的含量.

正常血糖水平为80- 120mg /dl (4.4-6.6更易/ L). 它可能上升到250- 300mg /dl (13.6-16.5 mmol/L). 然而, diabetes is the only common disease that will cause the blood glucose level to rise above 400 mg/dl (22 mmol/L). 一些糖尿病dogs的血糖水平会高达800毫克/分升(44 mmol/L), 尽管大多数都在400-600毫克/dl (22-33 mmol/L)的范围内.

防止身体失去葡萄糖, the kidneys do not allow glucose to be filtered out of the blood stream until an excessive level is reached. This means that dogs with a normal blood glucose level will not have glucose in the urine. 糖尿病的dogs, 然而, 血液中葡萄糖含量过高, 所以它会存在于尿液中.
 

这对我和我的dogsdogs有什么影响?

For the diabetic dog, one reality exists: blood glucose cannot be normalized without treatment. 虽然dogsdogs可以一天左右不接受治疗,不会有危机, 治疗应该被视为dogs的日常生活的一部分. Treatment almost always requires some 饮食ary changes and administration of insulin.
As for you, the owner, there are two implications: financial commitment and personal commitment.

当你的dogs被很好的管理,维护成本是最小的. 特殊的饮食、胰岛素和注射器都不贵. 然而, the financial commitment may be significant during the initial regulation process and if complications arise.

最初, your dog will be hospitalized for a few days to deal with the immediate crisis and to begin the regulation process. The “immediate crisis” is only great if your dog is so sick that it has quit eating and drinking for several days. 处于这种状态的dogs, 叫做酮症酸中毒, may require a week or more of hospitalization with quite a bit of laboratory testing. 否则, the initial hospitalization may be only for a day or two for basic tests and to begin treatment. 这时,你的dogs会回家让你给它吃药. At first, return visits are required every three to seven days to monitor progress. 可能需要一个月或更长时间才能实现良好的监管.

如果出现复杂情况,财政承诺可能又会很大. 你的兽医将与你一起努力,以达到一致的监管, 但是有些dogs很难被监管. It is important that you pay close attention to all instructions related to administration of medication, 饮食, 和家庭监控. Another complication that can arise is hypoglycemia, or low blood sugar, which can be fatal. 这可能是由于治疗不一致造成的. 这将在后面各段中解释.

Your personal commitment to treating your dog is very important in maintaining regulation and preventing crises. 大多数患有糖尿病的dogs需要每天注射一到两次胰岛素. 它们每天必须按照同样的时间表,吃同样数量的食物. If you are out of town, your dog must receive proper treatment while you are gone. These factors should be considered carefully when your pet has been diagnosed with diabetes mellitus.

治疗涉及什么?

一致性对糖尿病犬的适当管理是至关重要的. 你的dogs需要持续服药, 一致的喂养, 和一个稳定的, 无压力的生活方式. To best achieve this, it is preferred that your dog live indoors most of the time. 虽然这不是必要的, 室内生活消除了许多可能扰乱调节的不可控变量.

治疗的第一步是改变你的dogs的饮食. 糖尿病被称为“纤维反应性疾病”. Diets high in fiber are preferred because they are generally lower in sugar and slower to be digested. This means that the dog does not have to process a large amount of sugar at one time. Additionally, the fiber may help stimulate insulin secretion in Type II diabetes. Your veterinarian will discuss specific 饮食 recommendations for your pet’s needs.

你的dogs的喂食习惯也很重要. 有些dogs喜欢一天吃几次. 这意味着食物总是留在碗里供自由选择喂养. 然而,这并不是喂糖尿病dogs的最好方法. 首选的方式是每天喂食两次,就在每次注射胰岛素之前. If your dog is currently eating on a free choice basis, it is important to try and make the change. 如果每天喂食两餐对你不起作用, it is still important to find some way to accurately measure the amount of food that is consumed.

The foundation for regulating blood glucose is the administration of insulin by injection. 许多人最初害怕注射胰岛素. 如果这是你的第一反应,考虑以下几点:

1. 胰岛素注射时不会引起疼痛.
2. 注射用的是非常小的针,你的dogs几乎感觉不到.

The injections are given just under the skin in areas in which it is almost impossible to cause damage to any vital organ.
Please do not decide not to treat your dog with insulin until we have demonstrated the injection technique. You may be pleasantly surprised at how easy it is and how well your dog tolerates the injections.
 

胰岛素是如何提供的?

Insulin comes in an airtight bottle that is labeled with the insulin type and the concentration. It is important to make sure you match the insulin concentration with the proper insulin needles. 胰岛素针的计量单位为“单位/毫升”。, 这一定和你使用的胰岛素浓度一致吗.

在使用胰岛素之前,将其混合. 一定要用双手轻轻地滚动,不要摇晃. The reason for this is to prevent foam formation, which will make accurate measuring difficult. Some types of insulin used in dogs have a strong tendency to settle out of suspension. If it is not shaken properly, it will not mix well and dosing will be inaccurate. Therefore, the trick is to shake it vigorously enough to mix it without creating foam. 当你混合完胰岛素, turn the bottle upside down to see if any white powder adheres to the bottom of the bottle. 如果是这样,就需要更多的混合.

Insulin is a hormone that will lose its effectiveness if exposed to direct sunlight or high temperatures. 它应该保存在冰箱里,但不应该冷冻. 如果你对宠物的胰岛素和储存方式有任何疑问, 替代它比使用无效的胰岛素更安全. 只要按照指导使用,胰岛素是安全的, 但应该放在孩子够不到的地方.
 

我该如何注射胰岛素?

针头、注射器、胰岛素瓶和dogs准备好了吗. 然后,按照以下步骤:

1. Remove the cap from the needle, and draw back the plunger to the appropriate dose level.
2. 小心地将针插入胰岛素瓶.
3. 向瓶子里注入空气. 这就防止了真空在瓶内形成.
4. 将正确剂量的胰岛素注入注射器.

Before injecting your dog with the insulin, check that there are no air bubbles in the syringe. If you get an air bubble draw twice as much insulin into the syringe as you need. Then withdraw the needle from the insulin bottle and tap the barrel of the syringe with your fingernail to make the air bubble rise to the tip of the syringe. 向上移动柱塞,轻轻地、缓慢地排出气泡.

When this has been done, check that you have the correct amount of insulin in the syringe. 正确的胰岛素剂量是可以保证的,如果你从针端测量, 或注射器桶上的“0”, 在柱塞最靠近针头的一端.
 

我怎样注射胰岛素?

注射胰岛素的步骤如下:

右手拿注射器(如果您是左撇子,请换手). Have someone hold your dog while you pick up a fold of skin from somewhere along your dog’s back in the “scruff” region with your free hand. 试着每天挑一个稍微不同的地方.

快速地将非常锋利非常细的针穿过你的dogs的皮肤. 这应该是容易和无痛的. 然而, take care to push the needle through only one layer of skin and not into your finger or through two layers of skin. The latter will result in injecting the insulin onto your dog’s haircoat or onto the floor. The needle should be directed parallel to the backbone or angled slightly downward.

注射胰岛素, 把你的拇指放在柱塞上,把它推入注射器筒. 把针从你的dogs皮上取下来. Immediately place the needle guard over the needle and discard the needle and syringe. 抚摸和表扬你的dogsdogs,奖励它安静地坐着.

Be aware that some communities have strict rules about disposal of medical waste material so don’t throw the needle and syringe into the trash until you know if this is permissible. It is usually preferable to take the used needles and syringes to your veterinary clinic or local pharmacy for disposal.

It is neither necessary nor desirable to swab the skin with alcohol to “sterilize” it. 原因有四:

1. Due to the nature of the thick hair coat and the type of bacteria that live near the skin of dogs, 用酒精或其他防腐剂简单擦拭是无效的.

2. 因为少量的酒精可以通过针头穿过皮肤, 它可能会携带细菌进入皮肤.

3. 酒精引起的刺痛会让你的dogs不喜欢注射.

4. If you have accidentally injected the insulin on the surface of the skin, you will not know it. 如果您不使用酒精,并且皮肤或头发在注射后是湿的, 注射操作不当.

Although the above procedures may at first seem complicated and somewhat overwhelming, 它们很快就会变成第二天性. Your dog will soon learn that once or twice each day it has to sit still for a few minutes. 在大多数情况下, a reward of stroking results in a fully cooperative dog that eventually may not even need to be held.
 

是否需要持续或定期监测?

有必要定期bwin体育App你的dogs的进度. Monitoring is a joint project on which owners and veterinarians must work together.

家庭监控:

您在监视过程中的职责包括监视. You need to be constantly aware of your dog’s appetite, 重量, water consumption, and urine output. 你每天应该喂一定量的食物, which will allow you to be aware of days that your dog does not eat all of it or is unusually hungry after the feeding. 你应该至少每月称一次dogs的体重. 每次最好使用相同的刻度.

你应该发展一种测量用水量的方法. 一般的dogs应该喝不超过7 1/2盎司. (225毫升)水每10磅(4.5公斤)每24小时的体重. 因为这在不同的dogs身上变化很大, keeping a record of your dog’s water consumption for a few weeks will allow you to establish what is normal for your dog. Another way to measure water consumption is based on the number of times it drinks each day. 在适当的调控下,它每天不应超过六次. 如果超出了这个范围,您应该采取步骤进行实际的测量.

dogsdogs的食物摄入量有任何显著变化, 重量, 水的摄入, 或者尿量是糖尿病控制不好的标志. 那时bwin体育应该给你的dogs验血.

血糖监测:

有两种血液测试可以用来监测你的dogs, 血糖测试和果糖胺测试. One of these should be performed every three to four months if your dog seems to be well regulated. 在出现临床症状时也应随时进行检测.

测定血液中的葡萄糖水平是最有价值的. 当血糖确定时,时机很重要. 因为吃东西会使血糖升高几个小时, 最好在进食后至少6小时检测血液.

When testing the blood we want to know the highest and lowest glucose readings for the day. The highest blood sugar reading should occur just before an injection of insulin is given. 最低应发生在胰岛素作用高峰期. 这通常是注射胰岛素后的5到8小时, 但这应该在最初的监管过程中就确定下来. 因此,正确的程序如下:

Feed your dog its normal morning meal and insulin then bring it to the hospital immediately.

Blood samples will be obtained every 2-3 hours to determine the peak insulin effect.

在家里检测血糖是可能的. 如果您对家庭监控感兴趣,bwin体育将与您讨论选择.

替代测试被称为果糖胺测试. 这是过去两周血糖水平的平均值. 压力、饮食和锻炼的不一致性对它的影响较小. 对于一些dogs来说,这是首选的测试. 它不需要禁食,可以在一天中的任何时间进行.
 

dogs会发生低血糖吗?

Hypoglycemia的意思是低血糖. 如果低于40毫克/分升,可能会危及生命. 低血糖通常发生在两种情况下:

如果胰岛素剂量过高. Although most dogs will require the same dose of insulin for long periods of time, dogs的胰岛素需求可能会发生变化. 然而, the most common causes for change are a reduction in food intake and an increase in exercise or activity. dogs在注射胰岛素之前应该吃东西, 因为一旦注射了胰岛素就不能从体内移除. 如果你的dogs不吃东西,就不要给它注射胰岛素. 如果只吃了一半的食物,只注射一半剂量的胰岛素. Always remember that it is better in the short term for the blood sugar to be too high than too low.

如果胰岛素注射过多. This can occur because the insulin was not properly measured in the syringe or because two doses were given. You may forget that you gave it and repeat it, or two people in the family may each give a dose. A chart to record insulin administration will help to prevent the dog being treated twice.

The most likely time that a dog will become hypoglycemic is the time of peak insulin effect (5-8 hours after an insulin injection). When the blood glucose is only mildly low, the dog will act very tired and unresponsive. 您可能调用它,但没有得到响应. Within a few hours, the blood glucose will rise, and your dog will return to normal. Since many dogs sleep a lot during the day, this important sign is easily missed. 注意任何轻微的低血糖迹象. 这是问题迫在眉睫的第一个迹象. 如果您看到了,请带您的dogs来做血糖测试.

如果你的dogs从这段昏睡期恢复得很慢, 你应该给它玉米糖浆(一口一汤匙). If there is no response within fifteen minutes repeat administration of the corn syrup. If there is still no response, contact your veterinarian immediately for further instructions.

如果发生严重的低血糖,dogs可能会癫痫发作或失去意识. 最终,未经治疗的低血糖会导致昏迷和死亡. This is an emergency that can only be reversed with intravenous administration of glucose. If it occurs during office hours, take your dog to the veterinarian’s office immediately. 如果发生在晚上或周末, 拨打你兽医的紧急电话来获取指示.

这个客户信息表是基于Ernest Ward, DVM写的材料.
©版权所有2005 Lifelearn Inc. 使用许可下的许可. 2012年2月24日. 更新于2012年9月2日. 血糖仪图像由Shutterstock Images LLC和Photodictionary提供.com